Functional Treatment of Humeral Shaft Fractures

Abstract

Purpose: The aim of this study is to determine effectiveness of functional bracing for humeral shaft fractures. Material and
Methods: Between 1988-1999, functional brace was applied for 43 humeral shaft fractures of 42 patients as primary or secondary treatment of choice. Thirty-three of the patients were available for follow-up, ranged from 12.9 weeks to 94.3 weeks, with an average of 29.7 weeks. There were 7 female and 26 male patients. The average age was 30.12 years (range, 1 to 81 years).
Results: In these patients (3 open, caused by gunshot and 31 closed fractures) the average time to union was 16.7 weeks; the average varus-valgus angulation 8.1 degrees and the average anterior-posterior angulation, 11.8 degrees. After fracture healing has occurred, the functional situation was evaluated according to Hunter criterions. According to this, 12 patients had good (G3 and G4); 20 patients excellent (G5) functional results. Minimal restrictions of the abduction and lateral rotation of the shoulder joint were detected. None of the patients had lack of elbow motion. Angulatory deformities, that were found at the follow-up periods, had no effect on the function and cosmetic appearance. Only one patient required formal physical therapy after fracture healing completed. The complications we met, including 8, delayed union; 1, non-union and 1, maceration of the skin because of poor hygienic habits. The patient with non-union was treated with open reduction and plate-screw fixation, with successful outcome.
Discussion: Because of the low morbidity and high rate of success, we conclude that the first treatment choice of humeral shaft fractures, with acceptable indications, is the functional brace.